This study proposes to estimate and compare costs and effectiveness of two therapies for managing and treating urinary incontinence among the elderly--bladder training and use of absorbent briefs. Although not a life threatening condition, urinary incontinence affects the physical and psychological health of the elderly. Specific aims are: (1) estimate the psychosocial, health and resource costs of urinary incontinence among elderly; (2) estimate direct and indirect economic costs of two alternative therapies for urinary incontinence among elderly in nursing homes and in private residences; (3) identify factors affecting variant amounts of direct and indirect economic costs associated with urinary incontinence; (4) measure the effectiveness of alternative therapies for urinary incontinence in nursing homes and in private residences; (5) identify factors influencing effectiveness of alternative therapies for urinary incontinence among elderly in nursing homes versus family residences; (6) compare costs and effectiveness of alternative therapies for urinary incontinence among elderly in nursing homes and family residences; and (7) examine implications of financing alternative therapies for urinary incontinence among nursing homes and family residences. The research design for the proposed study will be based on random assignment of subjects to alternative conditions: a bladder training/habit retraining program and a program based on use of absorbent briefs. Samples will be drawn from two environments, long-term nursing care facilities and family residences in central Pennsylvania. This will be the first study to examine economic costs of caring for and treating urinary incontinence among elderly. It will also be the first study to scientifically examine the cost-effectiveness of alternative treatments among elderly with urinary incontinence. The medical economic data, the comparison of cost-effectiveness of alternative treatments, and the financing consequences among alternative settings (i.e., home versus institution), will provide fundamental and useful knowledge for providing health care services among elderly. In view of the pattern of increasing incontinency with increasing age and projected increases in the size of our elderly population, the results of this study should have important short- and long-term benefits for caregivers, policymakers and the elderly.